OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

Medicare Subsidy Quality Review

OMB 0960-0707 ยท SSA.

OMB 0960-0707

The Medicare Modernization Act of 2003 mandated the creation of the Medicare Part D prescription drug coverage program and provided for certain subsidies for eligible Medicare beneficiaries to help pay for the costs of prescription drugs. As part of its stewardship duties of the Medicare Part D subsidy program, SSA must conduct periodic quality review checks of the information Medicare beneficiaries report on their subsidy applications (Form SSA-1020). SSA uses the Medicare Quality Review program to conduct these checks. This is a non-substantive Change Request based on a legislative change due to the Inflation Reduction Act (IRA) (Public Law 117-169), Section 11404, which expands Medicare Part D Low Income Subsidy (LIS) Extra Help eligibility. We are making minor language changes to the form and instruction due to this legislative change.

The latest form for Medicare Subsidy Quality Review expires 2026-08-31 and is listed under ICR 202306-0960-003.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form SSA-9314 Notice of Quality Review Acknowledgement Form for those without Phones (Revised)Form and Instruction
Form SSA-9313 Notice of Quality Review Acknowledgement Form for those with Phones (Revised)Form and Instruction
Form SSA-9310 Request for DocumentsForm and Instruction
Form SSA-9308 Request for InformationForm and Instruction
Form SSA-9312 Notice of Appointment-Denial-Please Call ReviewerForm and Instruction
Form SSA-9311 Notice of Appointment-Denial-Reviewer Will CallForm and Instruction
Form SSA-9303 Notice of Appointment - Please Call Reviewer (Revised)Form and Instruction
Form SSA-9302 Notice of Appointment-Reviewer Will Call - Notice of Quality Review Acknowledgment Form for those with PhonesForm and Instruction
Addendum - 0707 (Final).docxSupplementary Document
Supporting Statement - 0707 (Final).docxSupporting Statement A
SSA-9301 Other-Telephone Interview Script - Medicare Subsidy Quality Revi
SSA-9314 Form and Instruction
SSA-9314 Other-Revised PA Statement
SSA-9313 Form and Instruction
SSA-9313 Other-Revised PA Statement
SSA-9310 Form and Instruction
SSA-9310 Other-Revised PA Statement
SSA-9308 Form and Instruction
SSA-9308 Other-Revised PA Statement
SSA-9312 Form and Instruction
SSA-9312 Other-Revised PA Statement
SSA-9311 Form and Instruction
SSA-9311 Other-Revised PA Statement
SSA-9303 Form and Instruction
SSA-9303 Other-Revised PA Statement
SSA-9302 Form and Instruction
SSA-9302 Other-Revised PA Statement

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202602-0960-007 Revision of a currently approved collection 2026-05-28
202306-0960-003 No material or nonsubstantive change to a currently approved collection 2023-07-20 Approved without change
202010-0960-008 Revision of a currently approved collection 2021-01-28 Approved without change
201706-0960-007 Revision of a currently approved collection 2017-10-20 Approved without change
201407-0960-004 Revision of a currently approved collection 2014-10-06 Approved without change
201110-0960-005 Revision of a currently approved collection 2012-01-19 Approved without change
201108-0960-003 No material or nonsubstantive change to a currently approved collection 2011-08-31 Approved without change
200812-0960-011 Revision of a currently approved collection 2008-12-31 Approved without change
200708-0960-007 Revision of a currently approved collection 2007-09-18 Approved with change
200704-0960-001 No material or nonsubstantive change to a currently approved collection 2007-04-03 Approved with change
200612-0960-015 No material or nonsubstantive change to a currently approved collection 2006-12-29 Withdrawn and continue
200602-0960-007 Revision of a currently approved collection 2006-02-10 Approved with change
200507-0960-001 New collection (Request for a new OMB Control Number) 2005-07-06 Approved with change

OMB Details

SSA-9301

Federal Enterprise Architecture: Income Security - General Retirement and Disability